Samenvatting pré-analytische fase
Inhoud
1. Inleiding....................................................................................................................................................................... 4
1.1. ISO NORM 15189..................................................................................................................................................4
1.2. Pré-analytische fase..............................................................................................................................................4
2. De testkeuze................................................................................................................................................................5
2.1. Aandachtspunten bij sectie van een test..............................................................................................................5
2.2. ROC-curve.............................................................................................................................................................5
3. De testaanvraag...........................................................................................................................................................5
3.1. Het aanvraagformulier..........................................................................................................................................5
3.2. Het verloop van de aanvraag................................................................................................................................6
3.3. Het laboratorium-informatiesysteem (LIS)............................................................................................................6
4. Bloedstalen.................................................................................................................................................................. 7
4.1. Soorten bloedstalen.............................................................................................................................................7
4.1.1. Volbloed.........................................................................................................................................................7
4.1.2. Serum............................................................................................................................................................7
4.1.3. Plasma...........................................................................................................................................................8
4.1.4. Hemolysaat....................................................................................................................................................8
4.1.5. Antistolling.....................................................................................................................................................8
4.2. Serum vs. heparineplasma..................................................................................................................................10
4.2.1. Significant verschillende resultaten.............................................................................................................10
4.3. Bewaringsomstandigheden van de bloedstalen.................................................................................................10
4.4. Integriteit van het bloedstaal..............................................................................................................................11
4.4.1. Hemolyse.....................................................................................................................................................11
4.4.2. Icterie (xantochromie).................................................................................................................................12
4.4.3. Lipemie........................................................................................................................................................12
4.5. Andere stalen......................................................................................................................................................14
4.5.1. Urinestaal....................................................................................................................................................14
4.5.2. Cerebrospinaal vocht (csv)...........................................................................................................................14
4.5.3. Arterieel bloed.............................................................................................................................................14
5. Beïnvloedende factoren op de samenstelling van het bloedstaal..............................................................................15
5.1. ‘Niet-variabele’ biologische factoren..................................................................................................................15
5.2. Variabele biologische factoren............................................................................................................................16
5.2.1. Tijdsgebonden fluctuaties............................................................................................................................16
5.2.3. Voeding........................................................................................................................................................17
5.2.4. Ondervoeding..............................................................................................................................................17
5.2.5. Fysieke inspanning.......................................................................................................................................17
5.2.6. Hoogte.........................................................................................................................................................17
1
, lOMoARcPSD|6865038
5.2.7. Stress...........................................................................................................................................................18
5.2.8. Levensstijl....................................................................................................................................................18
5.3. Interfererende proces-gerelateerde factoren.....................................................................................................18
5.3.1. Houding van de patiënt................................................................................................................................18
5.3.4. Verkeerde ratio bloed/anticoagulans...........................................................................................................19
5.3.5. Gebruik van een stuwband..........................................................................................................................19
5.3.6. Afname van bloed uit infuus-arm................................................................................................................19
5.3.7. Hemolyse.....................................................................................................................................................19
5.3.8. Te lang of foutief staaltransport...................................................................................................................19
6. De bloedafname........................................................................................................................................................20
6.1. De veneuze bloedafname...................................................................................................................................20
6.1.1. Belang..........................................................................................................................................................20
6.1.2. De voorbereiding.........................................................................................................................................20
6.1.3. De ontsmetting............................................................................................................................................22
6.1.4. Het vullen van de buis..................................................................................................................................22
6.1.5. Afwerken van de procedure.........................................................................................................................22
6.2. Capillaire bloedafname.......................................................................................................................................23
6.3. Veiligheid bij bloedafname.................................................................................................................................23
6.3.1. Uitvoerder....................................................................................................................................................23
7. Transport naar lab en bewaring.................................................................................................................................24
7.1. Bewaring staalafname........................................................................................................................................24
7.2. Wijze van transport.............................................................................................................................................24
7.3. Problemen bij bewaring en transport.................................................................................................................24
7.3.1. Lange transportduur of bewaring: uitwisseling...........................................................................................24
7.3.2. Lange transportduur of bewaring: hemolyse...............................................................................................24
7.3.3. Warmte........................................................................................................................................................24
7.3.4. In vitro metabolisatie...................................................................................................................................24
7.3.5. Foutieve buis................................................................................................................................................24
7.3.6. Verdamping.................................................................................................................................................24
7.3.7. Licht.............................................................................................................................................................25
7.3.8. Het pocket-syndroom..................................................................................................................................25
7.3.9. Belangrijke voorbeelden..............................................................................................................................25
7.4. Stalen voor het lab microbiologie.......................................................................................................................26
7.5. Bewaaromstandigheden voor een aantal analyses.............................................................................................26
8. Staalontvangst in het lab...........................................................................................................................................27
9. Staalvoorbehandeling in het lab................................................................................................................................27
Centrifugeren.........................................................................................................................................................27
Omgang met stalen na centrifugatie......................................................................................................................27
Inspectie van serum en plasma.............................................................................................................................28
2
, lOMoARcPSD|6865038
Onteiwitten............................................................................................................................................................28
Verdunnen.............................................................................................................................................................28
Homogeniseren na ontdooien...............................................................................................................................28
Automatisering in pré-analytische fase.................................................................................................................28
Transport naar analyzer.........................................................................................................................................28
10. Foutbronnen in de pré-analytische fase..................................................................................................................29
3
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller mltmdk. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.11. You're not tied to anything after your purchase.